Provider Demographics
NPI:1457092827
Name:EMERICK, MARIA LYNN (RDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LYNN
Last Name:EMERICK
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 IROQUOIS TRL STE 12
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-8644
Mailing Address - Country:US
Mailing Address - Phone:610-395-9595
Mailing Address - Fax:
Practice Address - Street 1:6750 IROQUOIS TRL STE 12
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-8644
Practice Address - Country:US
Practice Address - Phone:610-395-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDN007278133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH86110202OtherCOMMISSION ON DIETETIC REGISTRATION